Second Report of the Ministerial Task Force on Measures to Reduce the Demand for Drugs May, 1997 Second Report of the Ministerial Task Force on Measures to Reduce the Demand for Drugs May, 1997 SECOND REPORT OF THE MINISTERIAL TASK FORCE ON MEASURES TO REDUCE THE DEMAND FOR DRUGS CONTENTS Page Chairman’s introduction................................................................ 5 Summary of key recommendations ............................................... 11 Chapter 1 Introduction..................................................................................... 15 Chapter 2 Progress on implementation of the recommendations in our First Report........................................................................... 19 Chapter 3 Misuse of non-opiate drugs............................................................. 35 Chapter 4 Drug abuse in prisons and the treatment of prisoners who misuse drugs............................................................................ 55 Chapter 5 Role of the therapeutic communities in the treatment/rehabilitation of drug misusers.............................................................................. 65 3 Appendices 1. Terms of reference of the Ministerial Task Force on Measures to Reduce the Demand for Drugs 2. List of organisations and individuals who made submissions in relation to the Second Report 3. Analysis of submissions received 4. Guidelines to assist Local Drugs Task Forces in developing their anti-drugs strategies 4 Second Report of the Ministerial Task Force on Measures to Reduce the Demand for Drugs Chairman’s Introduction Politics is about people. People not simply reduced to individuals left to their own devices, atomised, without society, and with only a minimal State. Politics therefore is about people in society. Politics is about government, which is to say that it is about the appropriate relationship between the State and civil society. The idea of counterpoising the interests of people on the one hand to the political process and political institutions in our democracy on the other is a nonsense. The democratic State empowers people, which is to say it enables society. It enables social and mutual endeavour. It also empowers through interventions in its own right. It seeks to ensure - through institutions of State, through fiscal policy, public spending programmes, education, social policy and so on - equality of opportunity and also that degree of equality of outcomes without which society as such would cease to exist. Politics in a democracy must be responsive to public needs. Yet for far too long our State paid little attention to the rising drugs phenomenon, its causes, impact and consequences. For a decade and more, this State failed to tackle effectively the spread in the illicit trafficking and pushing of opiates, the destruction of the lives of individuals, the havoc 5 wrought in communities. It neglected adequately to address also the underlying forces at work in such communities that fed from within the drug phenomenon - their marginalisation within the formal economy; the geographical marginalisation that re-informed economic marginalisation; misguided approaches to public housing policy. Deficiencies in education and social policies also, for example, compounded the other forces at work. Work itself was made scarce in these communities. The result was a spiral of decline. The State also attended insufficiently to developments within youth culture. It did not meet the needs of our youth and it did not adequately address the concerns of young people and parents, particularly in urbanising Ireland. The State was late in recognising the power of peer pressure and many aspects of youth culture as it developed in the eighties. Parents’ need for information and guidance, the need for a harm reduction approach in the broadest sense to public health policy as it relates to youth culture, on all of this the State was slow to act. The result is to be seen today in the two ways. First of all it is to be seen in a situation that has been likened to a modern day equivalent of a TB epidemic. It is not a bad comparison. In the 1950s the TB epidemic induced strong, coherent, concerted and multifaceted State action. Resources were allocated. Facilities were provided. The harm to individuals and the cost of society was, over a period, reduced to a minimum. Secondly, the result of neglecting this phenomenon is to be seen in our society as a body politic, in the shape of frustration, cynicism, alienation, fear and disconnection from politics itself. These forces have taken root in the communities in which the heroin phenomenon is lodged. Many ordinary people, parents and otherwise, in these communities are turned off politics, forced into direct action and they are fearful. In the wider society also, there are the same phenomena as they see disorder, poverty and decay manifest. I am conscious of the fact that parents particularly are frustrated and fearful and, in the deprived “blackspots”, grandparents in many instances are having to return to parenting, this time their grandchildren, as a consequence of the havoc wreaked by heroin. We need education and information initiatives by the State at a number of levels - in our schools, in our youth, sport and recreational clubs and organisations and in the community at large. We 6 need to provide more specialist social, health and welfare services, targeted economic measures and urban and community renewal initiatives. This Government has moved in a concentrated and concerted fashion to deal with the drugs phenomenon, particularly within the last year. The international dimension to supply side measures has being strengthened. Criminal assets are being seized. And, in the shape of this Ministerial Task Force, there has been a major initiative on the demand side, with two dimensions emerging. We have begun directly to tackle the underlying forces - environmental improvement and so on. But also we have developed a strong philosophy of harm reduction and treatment of the consequences of drug abuse - stabilisation, methadone maintenance, detoxification, rehabilitation and re-integration. Established schemes such as Community Employment and new measures such as the Local Employment Scheme are being adapted to the need of the communities worst affected. On the non-opiates side, there are also a series of initiatives that overlap with the heroin problem but also go beyond it. Under the direction of the Department of Education, drug misuse programmes have been developed at both primary and second level schools and teachers and indeed parents are being trained to deliver these programmes. There are also the information programmes of the Health Promotion Unit at the Department of Health, aimed directly at young people. Taking a broader view and going beyond the remit of this Task Force, the Department of Health has produced its own alcohol awareness programme. The main policy objective of this programme is to promote moderation in alcohol consumption, for those who wish to drink, and reduce the prevalence of alcohol-related problems in Ireland, thereby promoting the health of the community. The strategic plan recently published by the Minister for Sport must also be seen in this general context. It is a plan that locates sport and State support of sport in a context much wider than simply the development and promotion of performance and high performance sport. The Plan embraces health and lifestyle, social, personal development and education dimensions - as well as the development of the high performance dimensions. 7 Now, in this Report, we advance some further measures for decision by the Government. Key among these is a public/private initiative for the development of youth, recreational and sporting facilities. In Chapter 3 of this Report, which deals with non-opiates and youth culture, the reader will find details of this proposed initiative. Heroin in the community was very much the focus of our First Report. The initiatives announced in the Report are now having a major impact, as is outlined in Chapter 2 of this Report. There, the reader will find a description of what is happening now in these communities, the impact of the initiatives, how the financial package of the First Report is working on the ground. There remains however another dimension - drugs in the prisons - which we indicated in our First Report is a special problem, deserving separate examination. Drugs and the prison system are dealt with the Chapter 4 of this Report. In that chapter the reader will find a description of the nature of the problem. It is not generalised within the prison system, it is a phenomenon that grips one institution in particular - Mountjoy. The Task Force discussed the problems at Mountjoy prison at some length. While it is strictly speaking an issue for prison policy generally, there was a strong feeling that there should be a serious examination of the issue of closing down Mountjoy and selling the site for urban development, with the revenues from the sale going into funding of the prison programme. The issue is whether a nineteenth century institution can ever be transformed into a modern, efficient and humane facility. We have concluded that, for as long as that prison continues to function as it now does, it will continued to be plagued with an internal drugs problem - smuggling and continued abuse within the prison. However, even if this problem were eliminated, there would still be a problem within the prison in